LAUSR

Patient P is a 3-year-old Chinese girl who presented to the outpatient specialist clinic with a referral from the general practitioner for main concerns of easy bruising. Prior to the consult, she sustained an extensive right forehead haematoma after a fall. The haematoma persisted and did not resolve completely even after 3 months. Her parents are non-consanguineous, and there was no prior family history of bleeding disorders or haematological conditions. She was a well child apart from being followed up previously at the general paediatrics clinic for faltering height centiles, growing along the third centile for height. She was born at full term via an elective caesarean section for maternal placenta praevia, with a good birthweight of 2.8 kg. On clinical examination, she was a cheerful girl with no dysmorphic features. She had a large forehead haematoma measuring 5 × 5 cm (Fig. 1) and was noted to have bruises of varying ages over the lower limbs.